Urinary diversion in the elderly patient.

Diversion and cystectomy have often been considered at length in the literature but little attention has been paid to the relevance and feasibility of these procedures performed specifically in the elderly patient. We describe here the results of urinary diversion in 45 patients of over 70 years of age. Most received an ileal conduit though ureterosigmoidostomy, cutaneous ureterostomy and transureterocutaneous ureterostomy were occasionally performed. In most patients diversion was done as part of a scheme of radical treatment of bladder cancer, but in others it was undertaken for palliative purposes or benign disease. The results of this retrospective study are sufficiently encouraging for us to continue to recommend such apparently extreme measures to patients whose life expectancy may be as much as 9 years. Furthermore diversion provides good palliation in preterminal disease. Moreover in patients with limited life expectancy ureterostomy should be seriously considered as a procedure which is quickly performed and with few early postoperative complications.